Elizabeth "Betsy" McCaughey (/məˈkɔɪ/; born Elizabeth Helen Peterken, October 20, 1948), formerly known as Betsy McCaughey Ross, was the 72nd Lieutenant Governor of New York from 1995 to 1998, during the first term of Governor George Pataki. She unsuccessfully sought the Democratic Party nomination for Governor after Pataki dropped her from his 1998 ticket, and ended up on the ballot under the Liberal party line.

A historian by training, with a Ph.D. from Columbia University, McCaughey has, over the years, provided conservative media commentary on U.S. public policy affecting healthcare-related issues. Her 1993 attack on the Clinton healthcare plan was likely a major factor in the initially-popular bill's defeat in Congress; also, it brought her to the attention of Republican Pataki, who chose her as his Lieutenant Governor nominee/running mate. In 2009, her criticisms of the Affordable Care Act -- then a bill being debated in Congress -- again gained significant media attention in TV and radio interviews, and may have specifically inspired the "death panel" claim about the act.

She has been a fellow at the conservative Manhattan Institute and Hudson Institute think tanks, and has written numerous articles and op-eds. She was a member of the boards of directors of medical equipment companies Genta (from 2001 to 2007) and Cantel Medical Corporation, until she resigned in 2009 to avoid the appearance of conflict-of-interest, given her public advocacy against the Affordable Care Act legislation.

Early life, education and family[edit]

McCaughey and her twin brother William were born in Pittsburgh, Pennsylvania to Albert Peterken, a factory janitor, and his wife, Ramona.[3][4] The family moved around the Northeastern United States for six years before settling down in Westport, Connecticut,[1] where McCaughey's father did maintenance, and later engineering work at a nail clipper factory.[2][5] McCaughey recalled her parents' difficulty in affording medical treatment: "my brother was a serious asthmatic as a child. I remember my parents sitting at the kitchen table wondering if they could afford to take [him] to the hospital."[1]

McCaughey attended public schools in Westport through the 10th grade, spending much of her free time at the library.[2] After receiving a scholarship, she transferred to a private Massachusetts boarding school, the Mary A. Burnham School, for her last two years of high school, rarely visiting home, either then or during her college years.[2]

While completing her Ph.D., McCaughey trained in the corporate banking department at Chase Manhattan Bank, and served as a loan officer in the Food, Beverage, and Tobacco Division.[10] She also took courses in accounting at Columbia's School of Business.[10]

McCaughey's father died in 1970 at the age of 60. Her mother, an alcoholic, died the next year of liver disease at the age of 42. [2][11] In 1972, she married Thomas K. McCaughey, a Yale graduate she had met in college and who was then moving up as an investment banker.[12] The McCaugheys separated in 1992 and divorced in 1994 with McCaughey and her ex-spouse sharing joint custody of their three daughters.[13] In January 1993 she filed an affidavit in her divorce proceeding in which she said she had no annual earnings from employment during most of the 18 years of her marriage to Thomas, and had never earned more than $20,000 per year, except in 1990, when she "sold an idea to Fox television for a windfall once-in-a-lifetime sum of $75,000".[12][14] She married wealthy investment banker and prominent Democratic Party fundraiser Wilbur Ross, Jr. in December 1995;[15] he filed for divorce in November 1998.[16]

Academic work, 1977-1988[edit]

McCaughey taught history as a Visiting Assistant Professor at Vassar College in 1977–1978, was a Lecturer at Columbia University in 1979–1980, and an Assistant Professor at Columbia University between 1981 and 1983, teaching two classes per year. Between 1983 and 1984 she had a National Endowment for the Humanitiespost-doctoral fellowship.[12][14] From 1986 to 1988, she served as a guest curator at the New-York Historical Society and was responsible for the museum's exhibit commemorating the bicentennial of the U.S. Constitution.[17] She also authored a book, "Government by Choice: Inventing the United States Constitution" that cataloged the exhibit.[17]

In February 1993, the John M. Olin Foundation funded a fellowship at the Manhattan Institute, a politically-conservative think tank, for McCaughey to write a book on race and the legal system to be titled Beyond Pluralism: Overcoming the Narcissism of Minor Differences. McCaughey wrote op-eds over the next six months in The Wall Street Journal and USA Today in which she supported the 1993 selection of a jury from predominately-white, Republican, rural counties for the urban (Memphis)-located retrial of African American and Democratic U.S. Representative Harold Ford, Sr.,[27] and praised the 1993 Shaw v. Reno U.S. Supreme Court decision (favoring five white voters who said their rights had been infringed upon by redistricting that had been done to comply with the Voting Rights Act).[28]

Healthcare reform, 1993-1994[edit]

On September 22, 1993, U.S. President Bill Clinton delivered a nationally televised speech about his healthcare reform plan to a joint session of Congress. From September 28–30, 1993, First Lady Hillary Clinton, the architect of the universal health care plan, testified about its details before five U.S. congressional committees. The cost of providing insurance for the estimated 37 million people who were then uninsured was to be covered in part by new taxes on tobacco.[29] On the last day of Hillary Clinton's testimony, The Wall Street Journal published an op-ed by McCaughey, who wrote that the 239-page draft legislation differed markedly from the White House's public statements and would have "devastating consequences".[30][31] Citing words and phrases from the draft, she argued that the 77 percent of Americans then covered by insurance would see a downgrade in their policies—-most would not be able to keep their own physicians and would be forced into price-controlled Health maintenance organizations (HMOs), which would provide only the most basic of care.[31] According to McCaughey, the HMO plans would not pay for visits to specialists or for second opinions, and most physicians would be driven out of private practice.[31]

In late November 1993, the Clinton health care plan of 1993 bill was introduced in the U.S. Congress and was made publicly available. The Wall Street Journal then published an op-ed by McCaughey in which said she had pored over the entire bill and concluded that it had price controls that would cause rationing, and that in her opinion, the bill was dangerous.[32][33]

McCaughey expanded her op-eds into a five-page article titled "No Exit", that appeared as the cover story in The New Republic and was published a few days before President Clinton's 1994 State of the Union address.[34] An internal memo by tobacco company Philip Morris, dated March 1994, indicated that representatives of Philip Morris had collaborated with McCaughey when she was writing "No Exit", stating:[35][36] "Worked off-the-record with Manhattan and writer Betsy McCaughey as part of the input to the three-part exposé in The New Republic on what the Clinton plan means to you. The first part detailed specifics of the plan."[36][37] (When the memo was discussed in a 2009 story in the Rolling Stone, McCaughey declined to comment.)[29][35]

McCaughey's "No Exit" article was quickly used by conservative officials and commentators seeking to discredit the Clinton plan.[38] Senator Bob Dole, in the Republican Party response to the President's State of the Union, used some of McCaughey's arguments of fewer choices, lower quality and more government control.[39]Bill Kristol's Project for the Republican Future quickly launched television advertisements featuring quotes from McCaughey's two Wall Street Journal op-ed columns and herTNR article. Newsweek columnist George Will used McCaughey's writings as a basis for predicting that the Clinton health plan would kill patients and make it illegal for patients to pay doctors directly for care—-with 15-year jail terms for patients who tried to do so.[40][41]

The Clinton White House press office issued a response to McCaughey's "No Exit" article, arguing that it contained "numerous factual inaccuracies and misleading statements."[42] McCaughey responded that her claims came "straight from the text of the bill".[43] Supporters of the Clinton plan questioned McCaughey's claims, including her statements that "the law will prevent you from going outside the system to buy basic health coverage you think is better," and that "doctor[s] can be paid only by the plan, not by you", by pointing to the text of the legislation such as[38] Section 1003 that said: "Nothing in this Act shall be construed as prohibiting ... An individual from purchasing any health care services." — House Bill 3600. February 4, 1994.[44]

According to The Washington Post, the "No Exit" article, the White House response, and the ensuing television and radio interviews with McCaughey made her a star, and, "Her toothy good looks, body-conscious suits, Vassar BA and Columbia PhD reduced right-wingers to mush".[12] The bill stalled and died in Congress in 1994, and the next year Clinton was reduced to asking Congress for a series of small, incremental reforms to the healthcare system.[45] The "No Exit" article won the National Magazine Award for excellence in the public interest. Andrew Sullivan, then the editor of The New Republic later stated that he believed there were flaws in McCaughey's article, but that he ran it "as a provocation to debate."[46] In 2006 a new editor recanted the story.[47]

In 2009, the Daily Beast called her "The Woman Who Killed Health Care".[48]

New York Lieutenant Governorship, 1994-1998[edit]

Following the national attention McCaughey received in the 1990s healthcare legislation debate, George Pataki, a first-year New York state senator who was running for governor, chose her as his lieutenant governor/running mate. Despite McCaughey's complete lack of experience as a political candidate or officeholder -- and the fact that Pataki did not personally know McCaughey -- Pataki perceived that she was very popular among conservatives (who, at the time, were still suspicious of him), and that her public image would make his long-shot candidacy more appealing to independent and women voters.[49] Regarding her status as a political rookie, McCaughey said, "Many New Yorkers see that as a plus."[6]

McCaughey said that she accepted the nomination believing she would be Pataki's "point person on health policy".[50] After winning the election, Pataki told The New York Times, McCaughey would have "very real and significant responsibilities" as lieutenant governor.[51] McCaughey was initially tasked by Pataki to work on education policy, and on reducing New York's Medicaid budget.[6] By January 1995, McCaughey had produced a set of recommendations that required cost-cutting by hospitals and nursing homes, so that the poor did not have to bear the entire burden of balancing the state's Medicaid budget (via a reduction of their benefits).[1] However, McCaughey's recommendations were largely ignored.[52] After Governor Pataki refused to give McCaughey permission to conduct a study into child abuse, she did one anyway, and publicly announced its results.[6] McCaughey was publicly critical of the governor's proposed cuts to Medicaid, and gave a pro-choice speech without his advance permission.[6] In March 1996, The New York Times reported that McCaughey was locked out of the governor's inner circle because she had violated the "unwritten rules" of the conventional lieutenant governor's role.[6] Rather than following protocol as lieutenant governor by taking a seat with everyone else during Pataki's State of State address to the legislature in 1996, McCaughey stood for the entire fifty-six-minute speech's length, further attracting attention to herself at her governor's expense.[53] In the spring of 1997, Governor Pataki announced that McCaughey would not be his running mate when he ran for re-election in 1998; he later selected New York State Supreme Court Justice Mary Donohue to replace her.

Though she had always voted Republican in presidential elections and taken conservative Republican policy positions, McCaughey suddenly switched her party affiliation to Democrat, and soon announced plans to run for governor against Pataki.[2] McCaughey was the early frontrunner for her new party's nomination process,[54] in part because of her statewide name and face recognition, and in part because of the financial support of her wealthy then-husband.[55] During her campaign for governor, she was criticized for firing a succession of campaign aides and political advisers, and for possibly changing her core political beliefs in order to appear more electable to New York voters.[2] As her opinion poll numbers sank, her then-husband took away more than half of the funds he had pledged to her campaign.[11]

McCaughey was defeated in the Democratic primary election by New York City Councilman Peter Vallone (who then lost the general election to Pataki, 54 percent to 33 percent). McCaughey had earlier received the nomination of the Liberal Party of New York for governor, and stayed in the general election. McCaughey's campaign attracted little support, and she received only 1.65 percent of the general vote for governor.[56] Following the election, she divorced and then sued her former husbands in "$40 million fraud," claiming that he promised to fund her campaign unconditionally.[11]

Life and career since leaving office[edit]

McCaughey has worked on patient advocacy and healthcare policy issues since leaving office in 1999. She was senior fellow at the conservative Hudson Institute beginning in 1999, then an adjunct senior fellow beginning in 2002.[10] She was a member of the board of directors of Genta, a company focused on the delivery of innovative products for cancer treatment from 2001 until she resigned in October 2007.[57] She was also a member of the board of directors of the Cantel Medical Corporation, a medical device manufacturer, from 2005 until she resigned in August 2009 to avoid the appearance a conflict of interest while she was engaged in advocacy on healthcare reform legislation.[58]

In 2004, she founded the Committee to Reduce Infection Deaths (RID) in reaction to a rise in anti-biotic resistant staphylococcus aureus and other hospital-borne infections.[59] The non-profit RID is "devoted solely to providing safer, cleaner, hospital care".[60] She remains the chairperson and representative of the organization.[60] She has appeared on Fox News, CNN and many radio shows to discuss her research and how to prevent infection deaths.[10] Her organization's efforts have led to legislation in more than 25 states requiring hospitals to report infections.[10]

In 2011, she was dating Oppenheimer Capital founder Charles Brunie.[61]

Healthcare reform, 2007-2009[edit]

American Cancer Society[edit]

In August 2007 the American Cancer Society dedicated $15 million to a public awareness campaign on inadequate access to healthcare for the 47 million Americans not covered by insurance.[62][63] The ACS claimed that there would be a greater decline in cancer deaths if more cases of cancer were diagnosed in the early stages.[62] The society noted that studies had shown that patients without insurance were more than twice as likely to have their cancer diagnosed in the late stages of the disease.[62] One of the cancer society's commercials stated, "We’re making progress, but it’s not enough if people don’t have access to the care that could save their lives."[62]

McCaughey criticized the ad campaign, saying the ACS should instead re-focus on educating people about cancer prevention and detection.[64] She argued that evidence had shown that the U.S. had higher rates of cancer survival than countries with universal healthcare coverage [64] due to shorter wait times for treatment, better availability of new drugs for therapy and more frequent cancer screenings.[64] She expanded her argument into a "Brief Analysis" published the following month by the National Center for Policy Analysis, in which she maintained that the U.S. was number one in the world in cancer care.[65] Sources for her analysis included a paper from the National Bureau of Economic Research, a non profit, non partisan research organization,[66] and an article in the British medical journal Lancet Oncology that analyzed 2000-2002 cancer survival figures from Europe.[67] The ACS responded by citing a study of nearly 600,000 cancer cases that concluded that compared to people with private insurance, uninsured patients in the U.S. were 1.6 times more likely to die within five years of their diagnosis.[68]

2009 stimulus bill[edit]

McCaughey published an op-ed on February 9, 2009 claiming that the Obama administration's pending economic stimulus legislation contained hidden provisions that would harm the health of Americans as well as the healthcare sector of the economy.[69] She argued that the bill would establish two powerful new bureaucracies; the National Coordinator for Health Information Technology, and the Federal Coordinating Council for Comparative Effectiveness Research.[69] McCaughey said the first entity would monitor patients' electronic medical records to ensure that doctors and hospitals treated patients in a way that "the federal government deems appropriate and cost effective", and that doctors and hospitals that deviate from the government's "electronically delivered protocols," would be penalized.[69][70] She said the Federal Coordinating Council would be composed of appointed bureaucrats charged with a cost-cutting agenda that would slow the development of new medical products and drugs, and ration healthcare for senior citizens.[69][71] She opined that the bureaucrats would use a comparative effectiveness formula that in the U.K. had resulted in a requirement that senior citizens go blind in one eye before the government would pay for a treatment to save the sight in the other eye.[69]

Critics claimed McCaughey's claims were distorted, pointing out that the National Coordinator for Health Information Technology was not new but had been created five years earlier by George W. Bush,[72] and that the 2009 legislation was not about limiting doctors' ability to prescribe treatments, but instead was about establishing a system of electronic records to give physicians complete and accurate information their patients.[73]FactCheck noted that comparative effectiveness research had been funded by the U.S. government for years, but agreed with McCaughey that there would be penalties for health providers that did not use the electronic records system.[74] The effectiveness research council was a new initiative, as McCaughey had said. However, supporters of the stimulus bill provision said the research that would be funded would provide additional evidence to guide treatment decisions, and would save lives and money by avoiding unnecessary, ineffective or risky treatments.[75]

McCaughey's viewpoint was soon echoed and extended by conservative talk show host Rush Limbaugh, and multiple Fox News Channel broadcasters.[73][75] Republican U.S. Representative Charles Boustany Jr. of Louisiana, a heart surgeon, added that he feared that comparative effectiveness research would be misused by federal bureaucrats to "ration care, to deny life-saving treatment to seniors and disabled people."[75] Other conservatives agreed that the legislation could put the federal government in the middle of the doctor-patient relationship.[75] The stimulus bill was passed with the healthcare related provisions still included and McCaughey urged their repeal, so that their potential impact could be studied further.[71]

2009 healthcare reform bills[edit]

McCaughey opposed the healthcare reform bills debated in Congress in 2009 and enacted in 2010. She made allegations about certain provisions of the bills that provided for Medicare payments to physicians for end-of-life and living will counseling, and about Ezekiel Emanuel, who was then an adviser to the Obama administration's budget director and chairman of the bioethics department at the National Institutes of Health.[76] McCaughey's claims may have inspired Sarah Palin's more high-profile claims that the legislation would lead to so-called death panels.[77][78][79][80] The provisions in the legislation that McCaughey advocated against were removed from the bill before it became law.

In July 2009, McCaughey claimed that a section in the pending healthcare legislation titled "Advance Care Planning Consultation" actually prescribed "euthanasia for the elderly" because it included provisions that "would make it mandatory … that people [on] Medicare [be told] how to end their lives sooner".[81][82] McCaughey's choice of words and analysis were described by The Atlantic'sJames Fallows as inaccurate and sensationalistic.[81] The fact-checking site, PolitiFact.com, responded that the end-of-life counseling was voluntary, and gave McCaughey a "pants on fire", (least true) rating.[82] In August 2009, WNYC's On the Media also addressed McCaughey's claims, concluding that the provision actually mandated that the federal government compensate "counseling sessions" on elder law, such as estate planning, "will writing and hospice care."[81]

McCaughey described Ezekiel Emanuel in a New York Post opinion article as a "Deadly Doctor" who advocated healthcare rationing by age and disability.[80] PolitiFact called this claim a "ridiculous falsehood."[82][83][84][85] FactCheck.org said, "Emanuel's meaning is being twisted ... he was talking about a philosophical trend, and ... writing about how to make the most ethical choices when forced to choose which patients get organ transplants or vaccines when supplies are limited."[86][87] An article in Time magazine said that Emanuel "was only addressing extreme cases like organ donation, where there is an absolute scarcity of resources", and quoted Emanuel as saying, "'My quotes were just being taken out of context.'"[77] The New York Times noted that Emanuel had, in fact, opposed the legalization of euthanasia or physician-assisted suicide when such proposal were being debated in the late 1990s.[76]

McCaughey resigned from the Board of Cantel Medical Corporation on August 20, 2009, "to avoid any appearance of a conflict of interest during the national debate over healthcare reform," according to a press release by the company.[58] Other reports opined that she resigned after negative reactions to her performance on The Daily Show with Jon Stewart, one day earlier.[88][89][90][91][92]

In an appearance on MSNBC's Morning Meeting on October 6, 2009,[93] McCaughey advocated gradually extending the minimum age for Medicare coverage upward from 65 years of age to 70 in order to keep the Medicare system solvent.

In a September 15, 2013 opinion piece in the New York Post entitled "Obamacare will question your sex life," McCaughey wrote "‘Are you sexually active? If so, with one partner, multiple partners or same-sex partners?" Be ready to answer those questions and more the next time you go to the doctor, whether it’s the dermatologist or the cardiologist and no matter if the questions are unrelated to why you’re seeking medical help. And you can thank the Obama health law."[95] The fact-checking site PolitiFact.com rated her assertion as "Pants on Fire," their lowest rating of truthfulness.[96] The fact-checking site FactCheck.org also called her assertion false.[97]

In an October 25, 2013 appearance on Fox News, McCaughey asserted that the Affordable Care Act would have the effect of "eviscerating Medicare."[98]

On her Twitter feed[99] and on television,[100] McCaughey asserted that members of Congress and other government employees were granted a "special subsidy" and a "premium illegally arranged by Obama" under the Affordable Care Act. The fact-checking site FactCheck.org found this assertion to be false.[101] The fact-checking site PolitiFact.com also found this assertion to be false,[102][103] as did fact-checkers at CNN[104]

In an August 20, 2009 appearance on "The Daily Show with Jon Stewart," McCaughey referred to the fact-checking site FactCheck.org as "spot-check dot org," claiming they failed to adequately read the House health care bill when they critiqued her assertions[105] that the health care bill contained a provision that would institute mandatory counseling sessions telling seniors how "to do what’s in society’s best interest...and cut your life short." In a rebuttal, FactCheck.org stood by their analysis and provided further analysis that led them to conclude that McCaughey had misinterpreted the bill.[106]

^ abU.S. Senate. "The Electoral College and direct election of the President: hearing before the Subcommittee on the Constitution of the Committee on the Judiciary, July 22, 1992," Washington: U.S. GPO, pp. 102–109, 112, 117–119, ISBN 0-16-041444-X.

^Porter, Henry. "The real McCaughey," Vanity Fair, May 1994, pp. 140–141. "Then last September, when she was reading about the health plan in the newspapers, she suddenly became obsessed ... What scholars do in these circumstances is go back to the original source. So she acquired a copy of the plan, took it to bed with her one evening, and ended up reading for most of the night."

^McCaughey, Elizabeth. "She's Baaack!," The New Republic, February 28, 1994.

^"H.R. 3600, The Health Security Act, Title I, Subtitle A". U.S. Government Printing Office. February 4, 1994. pp. 15–16. SEC. 1003. PROTECTION OF CONSUMER CHOICE. Nothing in this Act shall be construed as prohibiting the following: (1) An individual from purchasing any health care services. (2) An individual from purchasing supplemental insurance (offered consistent with this Act) to cover health care services not included within the comprehensive benefit package.

^Schwartzman, Paul (1996-06-02). "Lt. Gov Gets GOP Dissing". New York Daily News. Retrieved 2013-11-14. In perhaps the most bizarre element of this episode, McCaughey stood behind Governor Pataki, in full view of the camera, displaying an unflinching, toothsome smile for the duration of Pataki's speech.

^Jim Dwyer (August 25, 2009). "Distortions on Health Bill, Homegrown". The New York Times. Retrieved April 29, 2011. ... a former lieutenant governor of New York and now the quartermaster of much of the high-powered intellectual ammunition against the proposals. Ms. McCaughey has been the hammer to Ms. Palin’s nail.